Frequency of three complications [bleeding, laceration of external auditory canal and perforation of tympanic membrane] in patients with aural foreign bodies

To determine the frequency of three major complications of the foreign body in the external auditory canal i.e. the haemorrhage, the laceration and the perforation of the tympanic membrane. Cross sectional study. This study was conducted in the Department of ENT, Bahawal Victoria Hospital, Bahawalpur from 25-12-2012 to 24-09-2013. Total 284 cases that presented during nine months of duration were included in our study. General anaesthesia was used not only when initial attempt under direct visualization was unsuccessful, but also for those having history of previous attempts, and uncooperative patients. 25% of patients developed haemorrhage, 13.8% were having laceration while none of the patient presented with tympanic membrane perforation. Cotton bud was found to be the commonest foreign body [33.7%] and bleeding was associated with it. In this study, the cotton bud was found to be the commonest foreign body in external auditory canal. Use of cotton bud although is easy for cleaning of ears but if it is broken inside the external auditory canal, can cause serious complications like bleeding and laceration as found in this study. Public should be educated about this preventable medical emergency

Causes of recurrent pneumoniaamong children

Background: Respiratory tract infections remain the commonest cause of pediatric morbidity and mortality particularly in developing countries. A sub group of these children has recurrent pneumonia which may be the presentation of an underlying more serious systemic or local pathology

Objective: To determine the frequency of underlying causes of recurrent pneumonia, among pediatric patients

Patients and Methods: This descriptive study was conducted in the department of Pediatrics, Sheikh Zayed Hospital/ Medical College, Rahim Yar Khan, from 1[st] January, 2011 to 31[st] December, 2011. All the patients presented to the department and diagnosed as recurrent pneumonia were included in the study

Results: During the study period of one year, recurrent pneumonia was diagnosed in 292 patients. An underlying illness could be identified in 282 [97%] while in 10 [3%] cases the underlying cause could not be diagnosed. Underlying illnesses included neurodevelopmental disability in 183 [63%] cases, recurrent bronchiolitis with aspiration pneumonia 30 [10%], congenital heart disease 23 [8%], bronchiectasis 07 [2.3%], bronchial asthma 07 [2.3%], anomalies of the respiratory system 05 [1.7%], cleft palate 05 [1.7%], gastroesophageal reflux disease 04 [1.3%], down syndrome without CHD 04 [1.3%], severe malnutrition 03[1%], ciliary dyskinesia 03[1%], foreign body 02 [0.6%], thalassemia 02 [0.6%] and nutritional rickets 02 [0.6%]

Conclusion: Recurrent pneumonia is relatively common in our country as are recurrent respiratory tract infections. Common underlying illnesses included neurodevelopmental disability, recurrent bronchiolitis with aspiration pneumonia, congenital heart disease, down syndrome, bronchiectasis, bronchial asthma, anomalies of the respiratory system and cleft palate

Fetomaternal outcome in women with grandmultiparity and multiparity

To compare the maternal and neonatal outcome in multiparas and grand multiparas. Study. This prospective study was carried out in outpatient Department of Obstetrics and Gynaecology, Quaid-e-Azam Medical College, Bahawal Victoria Hospital, Bahawalpur from January 2009 to June 2009, A total of 380 deliveries were recorded in this study and divided into equal two groups A and B. The mean ages among the groups were not significantly different. Majority of the patients belong to the age groups of 31-35 years, With regards to gestational age, majority of the patients were found between 37-40 weeks of gestation in both groups [A and B]. We found 70.52% [n=134] with vaginal delivery in Group-B and 44.74% [n=85] in Group-A; abdominal delivery in 29.48% [n=56] in Group-B and 55.26% [n=105] in Group-A. Maternal morbidity regarding Anemia, APH, Stillbirth, PIH, Preterm delivery was analyzed and found a significant higher rate. Neonatal outcome with regards to Apgar score <6 at 1 minute, it was found present in 11.05% [n=21] in Group-A and 4.73% [n=9] in Group-B, while rest of patients i.e. 88.94% [n=169] in Group-A and 95.27% [n=181] in Group-B were found to have neonatal Apgar score of >6 at 1 minute. Grand multiparity is still a major obstetrics hazard in our set up with higher incidence of complications

Superficial cervical swelling in children; role of fnac in diagnosis - experience at Bahawalpur

Fine needle aspiration cytology [FNAC] is commonly used first line diagnostic test for palpable cervical swelling by ENT and Head and Neck surgeon. To analyze the diagnostic importance of FNAC by knowing its sensitivity and specificity in children having palpable cervical swelling. Prospective study. Department of ENT and Head Neck Surgery QAMC, Bahawalpur. July 2006 to June 2007. 82 cases of superficial cervical swelling with ages between 5 and 12 years were selected. Most of them were of poor socioeconomic class. All underwent FNAC for diagnosis and results were analyzed after comparing with histopathology examinations. Out of 432 total patients [of all ages] who attended the ENT department during the study period, only 82 were selected for the research which fulfilled the inclusion criteria. These were 5-12 years old, both sexes, 47 boys [57.3%] and 35 girls [42.75%]. Sixty eight [83%] patients had benign diseases while 14 patients [17%] had malignant lesions. Out of the 68 benign lesion [44.11%] were reaction hyperplasia [non specific inflammation], followed by tuberculous lymphadenitis [38.23%], cystic masses [5.88%], benign tumours [4.4%] and nodular goiter [7.35%]. Out of 14 malignant lesions, 6 [42.85%] had Hodgkin's Lymphoma, 2 [14.28%] had Non Hodgkin's Lymphoma, 3 [21.42%] patients had squamous cell carcinoma and 1 [7.14%] patient each of rhabdomyosarcoma, undifferentiated carcinoma and pleomorphic adenoma. In our study sensitivity and specificity of FNAC to diagnose the malignant lesion was 85.7% and 89.7% respectively. Accuracy of FNAC in our study was 89.0%. FNAC is highly helpful to diagnose the pathology of cervical swelling in children. It has high rate of sensitivity, specificity and accuracy to diagnose the malignancy in these lesions. Proper and specific sampling needs complete cooperation of the child and sedation may be necessary for this. Expertise is required for FNAC reporting

Clinical presentation of neonatal malaria

To study the prevalence, clinical presentation and laboratory findings in neonates suffering from malaria. Paediatrics Unit-I Bahawal Victoria Hospital, Bahawalpur from April 2006 to March 2008. Neonates with negative blood culture but positive slides for malarial parasites were included. The prevalence rate of neonatal malaria was 3.06%. 54% cases were due to plasmodium falciparum and 40% were due to plasmodium vivax while in 6% cases species could not be identified. The male to female ratio was 1.5:1. 46% cases presented within 7 days of birth. 80% cases were born by spontaneous vaginal delivery, 16% by spontaneous vaginal delivery with episiotomy while 4% by Cesarean section. Fever was present in 100%, hypothermia on examination in 4%, splenomegaly in 24%, hepatomegaly in 28%, jaundice in 30%, irritability in 52%, reluctant to feed in 8%, vomiting in 48%, cough in 8%, diarrhea in 50%, abdominal distension in 8%, seizures in 8%, apnoea in 4%, lethargy in 24%, respiratory distress in 28%, bloody stool in 4%, leucopenia in 6%, anemia in 40%, thrombocytopenia in 6% and hypoglycemia in 10% cases. There was no statistically significant difference in the clinical features or laboratory findings of malaria due to both the species. Neonatal malaria is, although, uncommon but resembles to that of neonatal sepsis and clinical presentation of malaria due to falciparum or vivax is same